Poisoning vs. Drug Overdose

August is Overdose Awareness Month, with August 31st being International Overdose Awareness Day. Waismann Method has joined forces with the Facing Fentanyl organization to promote National Fentanyl Prevention and International Overdose Awareness Day on August 21.

The national fentanyl overdose crisis is growing, and there is a need to differentiate between drug overdose and poisoning. The importance of this terminology and what this crisis continues to mean for those struggling with addiction-related problems, the medical community, and all of us, is the topic of this podcast with Clare Waismann, M-RAS/SUDCC II and David Livingston, LMFT.

Dwight Hurst, LPC: Welcome back to Addiction, Recovery and Mental Health, a podcast by Waismann Method Opioid Treatment Specialists. I’m your co-host, Dwight Hurst. I’m joined as always by Clare Waismann and David Livingston. We’re talking about overdose awareness, which is not a new topic for us. We have been talking about some of the alarming trends and statistics around overdose. And as it so happens, August is Overdose Awareness Month and Clare, Waismann Method has just joined up with an organization in relation to this. Right.

Clare Waismann, RAS/SUDCC: Correct. So we have been joining many, several different organizations. They are mostly organizations created by parents that lost their children to fentanyl poisoning. The goal of these organizations is truly to create awareness, you know, to other citizens and to parents. And because most of these kids died without knowing that they were taking fentanyl.

Dwight Hurst, LPC: And that’s one of the things I know that we had discussed a couple of episodes ago. We were talking about how some of these drugs and even false pills, fake pills that are being made with fentanyl, that there’s a oh, they said something like a one in three. If you take a random group of fake fentanyl-pressed pills that look like painkillers from a pharmacy, they said something like one in three of them could be fatal.

Clare Waismann, RAS/SUDCC: Correct.

Dwight Hurst, LPC: And often if you’re purchasing them, you don’t know that they’re fentanyl.

Clare Waismann, RAS/SUDCC: Especially because these kids, most of these kids that are dying, they had no tolerance because they were not opioid dependent. So, you know, they were at a party and somebody wanted to give them a Xanax or any other pills. And they took it and. They die immediately. It’s an extremely powerful drug and is just killing people at rates that they’re inconceivable. I’ve been doing this for 25 years and it is out of this world. What’s going on right now.

Dwight Hurst, LPC: It’s it becomes really messy when pulling apart these numbers then when we look at that, because one of the things you had brought up in this discussion was kind of “what is the definition of an overdose”? Because right now, wouldn’t that include people who are maybe like you said, or maybe even a first-time or brand new recreational user who we wouldn’t usually see represented as that statistic? And then so so we have poisoning deaths versus people who are overdosing, maybe in routine drug use and might also then experience a poisoning and die unexpectedly. And then, of course, you have intentional suicide, those that are suicidal as well. And they’re all kind of bulked together in these numbers, aren’t they?

Clare Waismann, RAS/SUDCC: They are. And that’s you know, that’s one of the things that these parents are fighting, you know, throughout social media is not to use the word overdose because they know there’s a stigma that goes with it. And they say, you know, well, they use illegal drugs, so they died. And, you know, regardless, regardless. And that’s how I feel. Guard Loss of how the person died. They died and they died because they took something that they were not aware of. So they’re seeing more as a poisoning, as even murder than in overdose. So they don’t even want to use that term per se, because it’s not like the victim decided to use a little more. They want to make a very clear distinction that I think is important because. What’s going on is very different than what went on ten years ago when there was, you know, the crisis, the opioid crisis, and everybody was overdosing because they were taking huge amounts of opioids. And that’s not making what happened ten years ago less said than, you know, what is happening right now. But it’s truly a different situation altogether.

Dwight Hurst, LPC: It’s interesting how it highlights, right? It highlights both the differences in the situation and also highlights just the oh, the hypocrisy and the distasteful stereotyping that people do just with any death that’s that is associated with drugs. Like we want to treat it like it’s less of a death because, oh, the person took the drugs. So therefore…

Clare Waismann, RAS/SUDCC: Correct.

Dwight Hurst, LPC: And this really draws that out where there’s a big, huge question mark and not even a question mark in general around, you know, people don’t know that they’re buying fentanyl.

Clare Waismann, RAS/SUDCC: Correct. So, you know, again, the parents are trying to make this distinction. So, um, to create awareness because most of these kids, as I said before, they are not opioid dependent and they are at risk, you know, by smoking something at a party or by taking a pill that they know they think is Adderall or oxy or. So it’s really important that we know that this new strain of fentanyl has nothing to do with the pharmaceutical fentanyl. This is an extremely, extremely powerful drug that one tiny little grain can kill you. And it could be, you know, inserted anywhere in any if you don’t buy it from a pharmacy, you are at risk. Is that simple? It doesn’t matter what you’re using.

Dwight Hurst, LPC: That’s the thought. It’s showing up in all kinds of unexpected places, right?

Clare Waismann, RAS/SUDCC: Correct. Correct. And sadly enough the data. For some reason, we always have a two-year-old data. So by the time we see it, two years have passed. So there is not the sense of urgency as if we saw what’s really going on. You know, currently how many people are dying from this every day. This is a tragedy that is going to affect generations to come. And I think the number 300 that they gave us for last year is not even close to what’s going on right now. And these kids are truly being murdered.

David Livingston, LMFT: It’s like you’re saying, Clare, it’s entirely different than it was ten years ago. It’s where most of the opioids were being or were coming from pharmacies. And now it’s that’s not it at all. It’s all most of what’s out there is fentanyl in some form or another that people are taking and using. It’s I hear it all the time. And, you know, when I’m talking to, especially the younger people, but it could be anybody you hear about so many people, you know, friends, friends of friends, things like that, who have overdosed. You can’t experiment anymore, you know, in kids. And that was kids used to do that. Kids did that forever. We can’t do that anymore. It’s you just can’t do it. It’s too dangerous. And so it’s critical that parents know that. It’s critical the kids and everybody knows it because the risk is just maybe one in three. I don’t know exactly what it is, but if you think about that, that’s just.

Clare Waismann, RAS/SUDCC: It’s the number one cause of death. Among Americans ages 18 to 45, more than COVID, more than heart attacks, more than murder, more than. And we are out there screaming for so many reasons. I don’t understand why we’re not screaming about this. I really don’t understand this. This is killing more people in our country than anything else as we speak. I mean, if you just open the news, you will see, um. That today, you know, today they found in Los Angeles. 1 million pills with fentanyl were seized in Englewood.

Dwight Hurst, LPC: Wow.

Clare Waismann, RAS/SUDCC: Exactly. Just for this today.

Dwight Hurst, LPC: For everything we seize. You know, there’s a whole bunch of other stuff out there.

Clare Waismann, RAS/SUDCC: That we don’t get exactly so. This is what we know, where it’s coming from. We know exactly where it’s coming from. We know where they’re being made. And it’s again, I don’t understand, especially with the ability of social media we have of reaching especially the young kids, you know, the 18 to not kids anymore to 40 years old. We have the ability to create such awareness with the platforms that are on people’s hands all day long. So why are there not warnings? These kids are buying these drugs through social media. If they are allowing the, you know, these dealers to sell. Why don’t at least they create, you know, awareness, education, warnings?

David Livingston, LMFT: Yeah.

Clare Waismann, RAS/SUDCC: It blows my mind that not just, you know, that those companies that can create awareness are not providing it, but how society is so quiet about it. I don’t understand.

Dwight Hurst, LPC: Yeah. Do you think that I’m interested to know people’s thoughts about this? Do you think that people’s hesitation to engage? I mean, I know that we talk about there being a lot of stigma and judgment. Do you think that there’s any other hesitation? Sometimes I wonder if people are afraid to admit that it really could happen to anyone. In other words, if I admit that, oh, this is a this is an endemic problem, this is something that could happen to anyone. We all need to do our part to try to fight it. If I admit that, that means that I can’t pretend that I know that my kids or even myself would always be safe from addiction. That’s a denial thing anyway, but I can’t pretend to believe it if I admit that it’s a problem I need to do something about. That’s just a that’s just something I’ve wondered over the years how many people are afraid to engage with this topic, afraid to admit that it could impact their lives?

Clare Waismann, RAS/SUDCC: I, I wish it was, but it’s I, I don’t believe it is.

David Livingston, LMFT: I mean, I think there’s there’s a number of reasons. There’s the medical profession that has sort of brought in substitute drugs, which people sometimes are successful with, but very often just substitute and come off it and go back to whatever else. And so that’s been one of the responses for from the medical community. You know, and then also getting people off it, like we do. I think people don’t know what to do is part of it. And, you know, and when you don’t know what to do. Just sometimes I think it’s easier, like you’re saying just to, you know, just kind of throw your hands up and also assume that it’s elsewhere. And very often it is elsewhere, but it’s but less and less and less. I mean, you know, pretty much all so many communities are getting hit by this, by so many different people, you know, dying that it still is mind-boggling. I’m trying to think both socially and psychologically and so forth. Why there wouldn’t be just speaking to what you’re both saying. Like like you’re saying, Clare, like it’s kind of mind-numbing that, you know, with COVID and things and I spoke about this, we shut down the whole country and the economy and everything. And, you know, and at one point, I mean, the deaths are, you know, they’re creeping into those levels. You know, I know it’s a different thing. And it’s not it’s not the same. But why there isn’t an outrage. It’s a good question.

Dwight Hurst, LPC: Yeah. I mean, I hear what you’re saying. It’s not airborne or whatever, but at the same time, so like some of the things might be different. But I also the passion attached to it is what you’re saying. Right? Like, why aren’t we at least? Yeah. Even just talking about it more than we are, you know?

David Livingston, LMFT: Well, there are so many social issues that I think are at the forefront of what, you know, I mean, just profoundly being dealt with and brought into schools and everything, you know. And so why isn’t this brought in at that level? Right. I mean, because it’s I mean, if you look at some of the really horrible things going on from mass shootings to other, you know, other things, this is taking lives that are at a rate that’s far, far, far beyond that.

Clare Waismann, RAS/SUDCC: But this is what I’m saying to you. So so, you know, not to take, obviously, the importance of any other tragedy going on in the world right now. Right. Right. You know, but this, the rate of, you know, this is taking lives of people. And again, last year, they were talking over 300 a day. This year, I can you know, this is likely to be so much higher, if not double. I mean, think about this. Think about if you had a jumbo plane falling with kids every day. Every day. A, you know, 787 would fall every day. Wouldn’t we stop flying?

Dwight Hurst, LPC: Yeah. It would be, yeah. No, you’d hope. At least.

David Livingston, LMFT: You hope. And.

Clare Waismann, RAS/SUDCC: And wouldn’t that be in every news possible?

David Livingston, LMFT: Right. Multiple planes.

Dwight Hurst, LPC: Well, we’d be talking about nothing but that, you know, obviously, it’s. Yeah. I wonder now, you had said a minute ago, Clare, that you thought the kind of the fear element, maybe I was being a little optimistic or I was chasing something. What do you feel like it is? Is it just the judgmental or the cynicism or the… What do you think?

Clare Waismann, RAS/SUDCC: No, I think, unfortunately, you know, uh, politics have, uh. No, no, no. I’m, you know, I’m straightforward. I think, unfortunately, politics, um, have taken over this country, have taken over people’s better judgment. Sense of, you know, of right or wrong, everything. So whatever the, um, pitch or agenda is ignored. You know, these drugs are crossing our borders freely and, you know, getting into every corner of our society. I mean, if you see the amount of people they’re dying in, if you see, you know, it’s every area, it’s every state. It’s not like, you know, a certain class of people or a certain state at a certain age. It’s just, you know, across the board.

Dwight Hurst, LPC: It’s an interesting thing. People don’t understand. I think about addiction is if you take a group of people suffering from addiction, it’s going to look very much like just going, driving around and granting, grabbing a random group of people from all different age groups, all different jobs, all different you know, people have a concept in their mind of what that group would look like. But, you know, it’s a fairly representative group if you look at who’s actually using.

Clare Waismann, RAS/SUDCC: Again, it’s I think we need to differentiate the same thing with fentanyl. When people talk about fentanyl, they say, oh, fentanyl has been used in this country for so long. This is not the fentanyl that we buy in the pharmacy. This is, you know, a strain that comes from China to Mexico to Mexico into this country and is so much more powerful and is being inserted in non-opioid drugs. And as David was saying, as a teenager, they try maybe teenagers that never did a drug in their lives and, you know, find themselves in a party and of the pressure. And they say, okay, I’m just going to take this pill. It’s just a Xanax or it’s just an Adderall.

Dwight Hurst, LPC: Right. And it’s not crazy to think that this one pill, certainly it wouldn’t be calibrated to kill a person if we think it came from a pharmacy, even if we are abusing it, even if I’m thinking this wasn’t prescribed for me, it would be bananas to think, Oh, just a random pill, one random pill from a bottle sitting in someone’s thing that they got over at Walgreens will definitely, probably kill me. That would be crazy to think it’s not. You know, we we like to attack the morals of people who use drugs recreationally. We like to attack their intelligence as part of that stigma. But it’s like a person at a party. You know, there’s not a huge difference there of saying, I know I shouldn’t, but I will. Between that and many other forms of substance use or intoxicant use that we look at as normal, you know, a person has a little too much to drink at a party and we and we chuckle and go, Oh, well, you know how they are, you know, so so with the exactly the same kind of thought process, someone is like, Yeah, all right, I’ll try this. And with no idea and no way that they necessarily I don’t want to say they know. Obviously, we can educate and we should, I guess, know better. And we do know better than to take a pill that we don’t know what it is. But if it’s something that came out of I assume someone’s medicine cabinet, I don’t I’m not entering into that choice with the right degree of alarm and information. R

David Livingston, LMFT: Right, is what I’m saying. And well, that’s it. And it’s, you know, then it’s being it’s made to look like other things, which it’s not. So it’s made to look like pharmaceutical, you know, medicine or some type of opioid that it’s not. And so it’s it’s literally, you know, when Clare says the word, use the word. I mean, we shouldn’t be using the word addiction or overdose. We should be using the word murder and poisoning because it really is what it is. Because it’s a I mean, imagine if somebody stuck something in your food, right? You think you’re getting one thing and you’re getting another, right? I mean I mean, how many restaurants.

Clare Waismann, RAS/SUDCC: An example as David, let’s say you know we as adults. Adults that are very aware of what’s going on. Let’s say you go on a vacation or somebody you can’t sleep or you have severe pain. And a friend of yours said, you know, I have a sleeping pill here if you want, just for the night. I have a pain pill here. If the pain is really bad, you’re traveling, you know, you’re a far away from your pharmacy or a doctor. You would take a pill like this? Probably. And I don’t know where that person got that pill. I would figure that they did in the pharmacy.

Dwight Hurst, LPC: Yeah. There’s a lot of that much more.

Clare Waismann, RAS/SUDCC: Very.

Dwight Hurst, LPC: Easy to admit.

David Livingston, LMFT: Right, right, right.

Clare Waismann, RAS/SUDCC: Exactly. So it’s very easy to say the kids are being bed, right? No, that’s not true.

David Livingston, LMFT: No, you’re 100% right. And you know, and often like like you’re describing that somebody is trying to take something really just more for medicinal or situational, and it’s and then they pass away. And that’s happening at a level that’s never happened before. And then kids who try things, they try things that’s there’s pressure on it. There’s you know, it’s talked about that’s talked about in the media and music. You know, this stuff is kind of glorified and that’s happened since, you know, since I can remember. I mean, you know, so kids try things and you know any rate it’s and why this isn’t being with all of the emphasis on making sure that there is awareness of, you know, of social changes and importance and allowing people to be themselves and all of that, you know, why isn’t this even as high a priority or even a higher one? I mean, it’s killing generations. I mean, you know, and it should it should be it should be upfront. It should be as big or bigger. I mean, and why isn’t the US government putting pressure on China to shut down these labs? You know, I mean, really.

Clare Waismann, RAS/SUDCC: Look at Sinaloa, that’s where they’re making these pills. They know where they are. But again, is what it’s what I’m saying to you. I think we’ve become so, you know, absorbed by our positions in politics. We lost our sense of humanity, our again, our sense of right and wrong.

Dwight Hurst, LPC: Yeah, I know that we’ve talked a lot about the way that people have felt and become out of touch and angry with each other so quickly. Do we do you feel like that affects this, the ability to talk about this as people being so estranged and angry at each other?

Clare Waismann, RAS/SUDCC: Listen, if we talk about this, okay, we have to say we got first thing we got to do is to stop the influx of this poison into every corner of our society.

Dwight Hurst, LPC: A lot of information about drug use is available online. So people at the same time that it’s never been more dangerous to mess around with drugs from the street. It’s also a time where people have information that when they think they know what they’re getting, they feel probably a little delusionally safe anyway going into it of like, Oh, I know what I’m doing. And it’s like, well, you know, this is a whole new thing with, with the increase of awareness. I was just thinking, what should we encourage people to do out there? One of the things I’m hearing is changing terminology. So is that something people can do is when they see social media posts or when they’re making social media posts for awareness, to start educating people, to start moving the terminology away from overdose and more towards death, murder, poisoning. Yeah.

Clare Waismann, RAS/SUDCC: Yeah. And I mean, and I think if, if, if the social media platforms are not willing, you know, to create the awareness that needs to happen. I think we as citizens should. You know, can you share something three or four times a day then do it? Yeah.

Dwight Hurst, LPC: Yeah. I mean, I know I’ve I’ve shared comments about Thor Ragnarok or that often. Right. And so I certainly could put something out there. I think we can use the time for that. It, it reminds me just the power of terminology. You know, if people make I’ve heard it said before that, you know, one of the most effective grassroots ways that we fight things like prejudice, for example, is like if someone tells that joke, we don’t laugh at that joke anymore. Someone may make some kind of a statement that is hurtful. And we say, Yeah, I don’t like I don’t want to hear that. Don’t say that to me. And so it’s kind of maybe a similar way here, though. The one would be just those terminology changes. And, you know, I also find that when people when you hear someone say something and you have more experience in education, it’s a little bit sometimes it’s intimidating. But to respond if you have a coworker or a friend or someone who says something judgmental about, oh, well, you know, they knew what they were in, blah, blah, blah, to turn and say, you know, do you really know much about what you’re talking about or some version of that of well, you know, what I’ve learned about addiction is this and maybe take that minute to push back a little bit and it might cost you a little bit of emotional turmoil or fear socially for a few seconds. But, you know, there’s a chance that the person you say it to or someone else in the conversation, it might open their mind a little and they might be a little more open and knowledgeable about addiction.

Clare Waismann, RAS/SUDCC: Yeah, there’s always going to be somebody sour out there to say something that is unproductive, but, uh, we got to do what we need to do, regardless of what others are doing. That’s what I believe in my life. On everything.

Dwight Hurst, LPC: Well, what other things do you think are useful for people to be doing?

Clare Waismann, RAS/SUDCC: I think awareness is number one. Education is number two. Talk to your children, especially if you have teenagers. Let them come to you, you know. And what are they going to say? I mean, David, you have teenagers. First thing they’re going to say, “I’m not an idiot,” right? I’m not going to do it. But I think if you just talk about it regardless, it’s going to be there. You know, behind their mind, they are at a party. Somebody offers something. Maybe they will remember what was said at that dinner table. I don’t know.

David Livingston, LMFT: Well, that’s it. I mean, you know, it’s terrifying. It’s just terrifying. My niece and nephew who have lost friends of theirs to this and kids just messing around a little bit. I’m pretty direct. I’m saying like, look, if you if you take this stuff, there’s a very good chance you’re going to die. You just need to know that it’s that bad. It’s that scary. I’m not kidding you. I’ve seen it more than you can even seen it or heard of it. And you can’t take pills anymore that you unless it’s from a doctor or pharmacy. And you know. Exactly it’s been prescribed you and so forth. You cannot take pills, period. It’s not what it once was. And there’s and there’s a lot of musicians who have died from it. And some of them have talked about it in their music a ton, you know, and and and so I’ll talk to my kids. I’ll say, yeah. And he’s and he’s they’re like, Yeah, he died, he overdosed. Or he, he well, I don’t know what happened. I mean, he died from, from I, I’m not sure what to call it, but because I don’t know exactly how it happened. But, but, yeah, so it’s, you know, it’s, that’s how I deal with it. And I also talk to, to the patients I’m working with just as directly. There’s no middle ground, you know, there’s just no middle ground.

Clare Waismann, RAS/SUDCC: No. It’s too dangerous out there to have any, you know, evidence about what you say or what you should say. That’s why, you know, when you say as well, then I’ll put it out there, talk about it. And if somebody say something negative, then be it.

Dwight Hurst, LPC: Mm-hmm. Yeah.

David Livingston, LMFT: Um.

Clare Waismann, RAS/SUDCC: So share with as many people as possible.

Dwight Hurst, LPC: Well, exactly. I just think I think we avoid sometimes, you know, we avoid those topics because it can feel unpleasant or weird or somebody, you know, says something ignorant or, you know, we just want to avoid the unpleasantness. But I think just like with other forms of education or other forms, those of us who let’s be fair, let’s be frank, oftentimes it’s it’s we’re in a privileged position to not be like the three of us right now. We’re not at risk of overdose. We’re I mean, I’m grateful that we’re not at a risk of of addictive relapse right now, that the three of us are in a place of our lives where that particular health problem isn’t threatening to us right now. Right. And this so we could sit here in this conversation and feel very free to say a fourth person wanders in and says something ignorant. All three of us could just roll our eyes in our inside and not have to challenge it. But let’s say if there’s five or six of us around and none of us say anything, and so then maybe the people who don’t know think we all agreed with what that person said, right?

David Livingston, LMFT: Yeah. So I like you. I don’t really care about the uncomfortableness. Maybe that’s a good thing or a bad thing, but.

Dwight Hurst, LPC: Hopefully, we get over that in the field a little bit. Probably, right?

David Livingston, LMFT: Yeah. Trust me, I’ve been told both, and I’m sure both the truth, but I don’t care about it. And not you know, this is an issue like you’re pointing out. This isn’t an issue where you can there’s no middle ground anymore. And, you know, and so the danger in saying that is there will be people who do take fentanyl and don’t die, but then there’s so many who take it and do die. So I know, I know. It’s what I’m saying is. But it’s just a matter of time. Right. And even the people who are taking it, I’ve talked to hundreds and hundreds and hundreds and they all say, yeah, I was starting to pass out. There were times I didn’t know if when I took it, if I was going to wake up. I mean, I hear it from everybody. So, so then the next question is, so how do you get people to a place really where they can feel the fear for themselves and they can’t they can want to be conscious and in a way that they want more than they want to be unconscious. And that and to do that, you cannot make them self-conscious in the wrong way because being self-conscious in the wrong way tends to drive the desire to be more unconscious. So you have to help people become conscious in the right way, which is what good education is and not making people feel horribly about who they are and just really trying to understand what their needs are and what their vulnerabilities are and all the stuff that happens, you know, in a more therapeutic process so that that they can bear their consciousness in the end and get used to sort of and, you know, not need that feeling of trying to be more unconscious, which is and find healthier ways to play and forget about things and relax. And, you know, and and that’s a developmental thing. It takes some time.

Dwight Hurst, LPC: And we’re going to leave it there. Thank you so much for listening. Just by being interested in and curious about addiction, you’re showing that you have the right kind of attitude and that you’re the right kind of person to do just the things we’re talking about by spreading appropriate awareness and education out there about addiction and about recovery and treatment for people. This show is a production of the Waismann Method Opioid Treatment Specialists. Learn more about us and our detox treatment programs at opiates.com. Email us info@opiates.com Or follow us on Twitter @opiates. We’d love to hear from you and to hear your questions about mental health and addiction treatment. The music for the podcast is the song Medical by Clean Mind sounds. For Clare Waismann and for David Livingston and Waismann Treatment Specialists. I’ve been Dwight Hurst. Thanks for listening. Remember to keep asking questions. The more you ask questions, the closer you move to getting answers. And whenever you find answers, you can find hope. Have a great day. We’ll be back with you again soon.